EP1276488A1 - Utilisation d'une bacterie lactique destinee au traitement de la peritonite - Google Patents

Utilisation d'une bacterie lactique destinee au traitement de la peritonite

Info

Publication number
EP1276488A1
EP1276488A1 EP01936125A EP01936125A EP1276488A1 EP 1276488 A1 EP1276488 A1 EP 1276488A1 EP 01936125 A EP01936125 A EP 01936125A EP 01936125 A EP01936125 A EP 01936125A EP 1276488 A1 EP1276488 A1 EP 1276488A1
Authority
EP
European Patent Office
Prior art keywords
peritonitis
lactic acid
use according
acid bacterium
treatment
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
EP01936125A
Other languages
German (de)
English (en)
Other versions
EP1276488B1 (fr
Inventor
Eduardo Schiffrin
Carlos Hosp. Santa Creu i Sant Pau GUARNER
German Hosp. Santa Creu i Sant Pau SORIANO
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Societe des Produits Nestle SA
Nestle SA
Original Assignee
Societe des Produits Nestle SA
Nestle SA
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Societe des Produits Nestle SA, Nestle SA filed Critical Societe des Produits Nestle SA
Priority to EP01936125A priority Critical patent/EP1276488B1/fr
Publication of EP1276488A1 publication Critical patent/EP1276488A1/fr
Application granted granted Critical
Publication of EP1276488B1 publication Critical patent/EP1276488B1/fr
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/66Microorganisms or materials therefrom
    • A61K35/74Bacteria
    • A61K35/741Probiotics
    • A61K35/744Lactic acid bacteria, e.g. enterococci, pediococci, lactococci, streptococci or leuconostocs
    • A61K35/747Lactobacilli, e.g. L. acidophilus or L. brevis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/66Microorganisms or materials therefrom
    • A61K35/74Bacteria
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23LFOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L29/00Foods or foodstuffs containing additives; Preparation or treatment thereof
    • A23L29/065Microorganisms
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23LFOODS, FOODSTUFFS, OR NON-ALCOHOLIC BEVERAGES, NOT COVERED BY SUBCLASSES A21D OR A23B-A23J; THEIR PREPARATION OR TREATMENT, e.g. COOKING, MODIFICATION OF NUTRITIVE QUALITIES, PHYSICAL TREATMENT; PRESERVATION OF FOODS OR FOODSTUFFS, IN GENERAL
    • A23L33/00Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof
    • A23L33/10Modifying nutritive qualities of foods; Dietetic products; Preparation or treatment thereof using additives
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K35/00Medicinal preparations containing materials or reaction products thereof with undetermined constitution
    • A61K35/66Microorganisms or materials therefrom
    • A61K35/74Bacteria
    • A61K35/741Probiotics
    • A61K35/744Lactic acid bacteria, e.g. enterococci, pediococci, lactococci, streptococci or leuconostocs
    • A61K35/745Bifidobacteria
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/04Drugs for disorders of the alimentary tract or the digestive system for ulcers, gastritis or reflux esophagitis, e.g. antacids, inhibitors of acid secretion, mucosal protectants
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • A61P1/16Drugs for disorders of the alimentary tract or the digestive system for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/04Antibacterial agents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P41/00Drugs used in surgical methods, e.g. surgery adjuvants for preventing adhesion or for vitreum substitution
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23VINDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2002/00Food compositions, function of food ingredients or processes for food or foodstuffs
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23VINDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2400/00Lactic or propionic acid bacteria
    • A23V2400/11Lactobacillus
    • A23V2400/151Johnsonii
    • AHUMAN NECESSITIES
    • A23FOODS OR FOODSTUFFS; TREATMENT THEREOF, NOT COVERED BY OTHER CLASSES
    • A23VINDEXING SCHEME RELATING TO FOODS, FOODSTUFFS OR NON-ALCOHOLIC BEVERAGES AND LACTIC OR PROPIONIC ACID BACTERIA USED IN FOODSTUFFS OR FOOD PREPARATION
    • A23V2400/00Lactic or propionic acid bacteria
    • A23V2400/51Bifidobacterium
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S435/00Chemistry: molecular biology and microbiology
    • Y10S435/8215Microorganisms
    • Y10S435/822Microorganisms using bacteria or actinomycetales
    • Y10S435/853Lactobacillus

Definitions

  • the present invention pertains to the use of lactic acid bacteria capable to adhere to the intestine's mucosa and essentially colonize it for the treatment of disorders associated with peritonitis.
  • the present invention relates to the use of such lactic acid bacteria for the treatment of peritonitis' associated with liver cirrhosis.
  • Peritonitis is an inflammation of the peritoneum, attributable to a severe local infection regularly resulting from gastrointestinal inflammation and infection, gastro-intestinal perforation and trauma, including surgery or peritoneal dialysis. To this end, pathogenic and potentially pathogenic microorganisms and occasionally cellular debris enter the peritoneum and elicit an immune response by the host, which may often not cope with the challenge of the pathogenic invasion.
  • SBP spontaneous bacterial peritonitis
  • a major jeopardy of peritonitis is bacterial dissemination, i.e. the spread of the pathogens via the blood and lymph systems, resulting in the infection of diverse tissues and leading to a life threatening situation for the affected individual. Once bacteria have entered the peritoneal cavity, dissemination is quite rapid. Within 6 minutes of intraperitonal inoculation of bacteria in dogs, thoracic lymph has been found culture-positive, while within 12 minutes elevated bacterial levels in the bloodstream may be found.
  • the typical medical treatment for the prevention and/or treatment of peritonitis includes antibiotic therapy, especially prior to surgical procedures.
  • This approach suffers, however, from the drawback ofdeveloping drug resistant bacteria known to cause peritonitis.
  • peritonitis may be caused by both gram-positive and gram-negative microorganisms, the use of an antibiotic may not be sufficient in all cases.
  • antibiotic treatment is non-specific, also exterminating many non-pathogenic microorganisms which commonly prevent bacterial diseases through bacterial antagonism, in particular in the gastrointestinal tract. Therefore, in applying broad spectrum antibiotics for prolonged periods the growth of most of the bacteria fostering in the intestinal tract is suppressed with the result of antibiotic resistant strains of pathogenic micro-organisms freely propagating. In consequence, antibiotics may occasionally foster peritonitis, rather than prevent it.
  • WO 97/00081 Another approach for the treatment of peritonitis is disclosed in WO 97/00081.
  • This document suggests the use of antagonists to CD 14, a surface antigen known to interact with lipopolysaccharides of bacterial origin.
  • Bacterially derived lipopolysaccharides are known to be capable to stimulate the immune system by binding to cell surface receptors of cells of the immune system which in turn start to produce and secrete cytokines and other mediators, that stimulate the immune system.
  • said cytokines or mediators, respectively have also been found to be able to support bacterial growth and invasiveness.
  • the gist of the treatment proposed therefore lies in an interruption of the early immune response during which the cytokines/mediators are produced.
  • An object of the present invention is therefore to provide such a means.
  • lactic acid bacteria in the gut of an individual may have a positive influence on the cells of the immune system in the peritoneum, especially on the cells of the immune system adjacent to the intestine. It has been found that the administration of particular lactic acid bacteria obviously reduce the number of bacterial counts in the ascites and the peritoneum, respectively, of animals suffering from peritonitis, showing that lactic acid bacteria bacteria, in particular probiotic lactic acid bacteria bacteria are able to efficiently decrease intestinal bacterial overgrowth and translocation of pathogens.
  • the peritonitis may be a spontaneous bacterial peritonitis (SBP) such as is caused by the sudden appearance of potential pathogens in the peritoneum, which often concurs with a deficiency of liver function, such as during a cirrhotic state thereof.
  • SBP spontaneous bacterial peritonitis
  • the peritonitis may well be virally induced or a peritonitis following dialysis or surgery.
  • the lactic acid bacterium is a probiotic lactic acid bacterium, preferably from the genus Lactobacillus or Bifidobacterium, and is more preferably Lactobacillus johnsonii CNCM 1-1225, Lactobacillus paracasei CNCM 1-2116 or Bifidobacterium CNCM 1-2168.
  • the lactic acid bacterium to be used is incorporated in the carrier which may be a food or a pharmaceutical product, such as e.g. milk, yoghurt, curd, cheese, fermented milks, milk based fermented products, ice-creams, fermented cereal based products, milk based powders, infant formulae and in forms of tablets, liquid bacterial suspensions, dried oral supplements, wet oral supplement, dry tube feeding or wet tube feeding etc.
  • a food or a pharmaceutical product such as e.g. milk, yoghurt, curd, cheese, fermented milks, milk based fermented products, ice-creams, fermented cereal based products, milk based powders, infant formulae and in forms of tablets, liquid bacterial suspensions, dried oral supplements, wet oral supplement, dry tube feeding or wet tube feeding etc.
  • the carrier may well include other compounds known to be beneficial to an impared situation of the gut, e.g. antioxidants, such as Vit C, Nit E, Selenium or Zinc.
  • antioxidants such as Vit C, Nit E, Selenium or Zinc.
  • the person skilled in the art will choose the appropriate galenic form and/or supplements, assisting in improving the individual's health.
  • Probiotics are known to have a beneficial effect on the host's immune system. In the present case it seems as if the lactic acid bacteria are capable to stimulate the immune system in the peritoneum and in particular the non-specific immune defense, located around the individual's gut to combat microorganisms invading the peritoneum through the intestine's walls. This immune barrier is normally weakened in patients suffering from liver cirrhosis.
  • the lactic acid bacteria colonizing the intestine's wall will physically prevent or at least reduce the number of potential pathogens invading the peritoneum via the gut.
  • the bacteria Through adhesion to the intestine the bacteria obviously establish a close contact with the intestinal mucosa masking receptors of the intestine's surface for pathogens.
  • the activity of the micro-organisms is dose dependent with the effect that the more micro-organisms are incorporated by means of ingesting the food or pharmaceutical composition, respectively, the higher the protective and/or curing activity.
  • the food or pharmaceutical composition to be used according to the present invention may contain the lactic acid bacterium in an amount from about 10 s cfu/g to about 10' 2 cfu/g carrier.
  • the abbreviation afternooncfu shall designate a perennial colonny forming unit" that is defined as the number of bacterial cells as revealed by microbiological counts on agar plates.
  • micro-organisms used are not obnoxious to civilization and animals and have eventually been isolated from a natural surrounding, namely baby feces, a high amount thereof may be incorporated so that essentially a high proportion of the individuals intestine may be colonized by the micro-organisms.
  • a total of 31 male Sprague-Dawley rats were included in the study with 19 thereof being made cirrhotic by weekly intragastric administration by gavage of carbon tetrachloride and water with phenobarbital (1.5mmol/l) ad libitum.
  • the diet has been standard B&K (Barcelona, Spain) and was available for the rats ad libitum.
  • the 12 rats from control group received standard diet (supra) and water with phenobarbital during all the study, while the other rats (19) of the test group received the standard diet inclusive the lactic acid bacterium CNCM 1-1225 (Lactobacillus johnsonii, Lai) in an amount of about 10 10 cfu/day or water.
  • All control rats were killed 18 weeks after they began to drink water with phenobarbital. From 12 control rats, 6 received treatment A (water) and 6 treatment B (water plus lactobacillus). The treatment was administered by gavage. Laparotomy was performed under anesthesia after 10 days of respective treatment or no treatment and samples of cecal feces, ileal feces, ileum wall, mesenteric lymph nodes and ascitic and pleural fluid were collected for the microbiological study. Blood was collected from cava vein to determine endotoxemia. In addition, samples of ileal wall, cecal wall, spleen and liver were collected for histological study, and portal pressure was assessed both by portal vein puncture and the ratio spleen weight/rat weight.
  • a study of intestinal permeability by the determination of lactulose and mannitol in urine was performed to all the control and cirrhotic rats during the 24 hours previous to the beginning of treatment and at the end of treatment. Moreover, the study of intestinal permeability was performed to all the control and cirrhotic rats every 4 weeks through the period of induction of cirrhosis or control.
  • 5/8 rats showed bacterial translocation (positive cultures) to mesenteric lymph nodes or ascitic or pleural fluid (p ⁇ 0.01 with respect to groups receiving treatment A and B): 2 to pleural fluid, 2 to mesenteric lymph nodes , and 1 to pleural and ascitic fluid and to mesenteric lymph nodes.
  • Bacteria isolated were: 2 Escherichia coli, 2 E. coli + enterococcus, and 1 E. coli + streptococcus.
  • treatment B decreased bacterial counts of enterobacteria and enterococcus and increased lactobacillus when compared to rats treated with water. Therefore, treatment B may correct the bacterial overgrowth of potentially pathogenic bacteria in cirrhotic rats.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Medicinal Chemistry (AREA)
  • General Health & Medical Sciences (AREA)
  • Mycology (AREA)
  • Microbiology (AREA)
  • Engineering & Computer Science (AREA)
  • Organic Chemistry (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Molecular Biology (AREA)
  • Epidemiology (AREA)
  • Polymers & Plastics (AREA)
  • Nutrition Science (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Food Science & Technology (AREA)
  • Communicable Diseases (AREA)
  • Oncology (AREA)
  • Pain & Pain Management (AREA)
  • Rheumatology (AREA)
  • Surgery (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)
  • Micro-Organisms Or Cultivation Processes Thereof (AREA)
  • Dairy Products (AREA)
  • Confectionery (AREA)
  • Coloring Foods And Improving Nutritive Qualities (AREA)

Abstract

L'invention concerne l'utilisation de bactéries lactiques capables d'adhérer à la muqueuse intestinale et de la coloniser presque complètement afin de traiter des troubles associés à la péritonite. L'invention concerne, plus particulièrement, l'utilisation de ces bactéries lactiques dans le traitement de la péritonite provoquée par la cirrhose du foie.
EP01936125A 2000-03-24 2001-03-22 Utilisation d'une bacterie lactique destinee a la prevention de la peritonite Expired - Lifetime EP1276488B1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP01936125A EP1276488B1 (fr) 2000-03-24 2001-03-22 Utilisation d'une bacterie lactique destinee a la prevention de la peritonite

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
EP00106441 2000-03-24
EP00106441 2000-03-24
EP01936125A EP1276488B1 (fr) 2000-03-24 2001-03-22 Utilisation d'une bacterie lactique destinee a la prevention de la peritonite
PCT/EP2001/003271 WO2001070246A1 (fr) 2000-03-24 2001-03-22 Utilisation d'une bacterie lactique destinee au traitement de la peritonite

Publications (2)

Publication Number Publication Date
EP1276488A1 true EP1276488A1 (fr) 2003-01-22
EP1276488B1 EP1276488B1 (fr) 2006-12-20

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ID=8168228

Family Applications (1)

Application Number Title Priority Date Filing Date
EP01936125A Expired - Lifetime EP1276488B1 (fr) 2000-03-24 2001-03-22 Utilisation d'une bacterie lactique destinee a la prevention de la peritonite

Country Status (22)

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US (2) US7217414B2 (fr)
EP (1) EP1276488B1 (fr)
JP (1) JP2003527432A (fr)
KR (1) KR20020087418A (fr)
CN (1) CN1183916C (fr)
AR (1) AR028288A1 (fr)
AT (1) ATE348626T1 (fr)
AU (1) AU783439C (fr)
BG (1) BG107096A (fr)
BR (1) BR0109496A (fr)
CA (1) CA2403491A1 (fr)
DE (1) DE60125345T2 (fr)
ES (1) ES2276793T3 (fr)
HK (1) HK1052465B (fr)
HU (1) HUP0301059A3 (fr)
IL (2) IL151596A0 (fr)
MX (1) MXPA02009342A (fr)
NO (1) NO20024488L (fr)
PL (1) PL358214A1 (fr)
UA (1) UA76104C2 (fr)
WO (1) WO2001070246A1 (fr)
ZA (1) ZA200208592B (fr)

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MXPA04008187A (es) * 2002-02-21 2004-11-26 Nestle Sa Composicion de alimento para mascotas, para la fotoproteccion de la piel.
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AU2010247469B2 (en) * 2009-05-11 2014-12-18 Société des Produits Nestlé S.A. Lactobacillus johnsonii La1 NCC533 (CNCM I-1225) and immune disorders
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AU783439C (en) 2006-12-14
PL358214A1 (en) 2004-08-09
US7217414B2 (en) 2007-05-15
NO20024488D0 (no) 2002-09-19
HK1052465A1 (en) 2003-09-19
EP1276488B1 (fr) 2006-12-20
AR028288A1 (es) 2003-04-30
BR0109496A (pt) 2002-12-10
MXPA02009342A (es) 2003-09-22
US20030044397A1 (en) 2003-03-06
US20070172512A1 (en) 2007-07-26
HUP0301059A3 (en) 2004-10-28
JP2003527432A (ja) 2003-09-16
IL151596A0 (en) 2003-04-10
US7678370B2 (en) 2010-03-16
ZA200208592B (en) 2004-02-10
CN1183916C (zh) 2005-01-12
NO20024488L (no) 2002-09-19
IL151596A (en) 2008-07-08
BG107096A (bg) 2003-05-30
CA2403491A1 (fr) 2001-09-27
AU783439B2 (en) 2005-10-27
ATE348626T1 (de) 2007-01-15
KR20020087418A (ko) 2002-11-22
WO2001070246A1 (fr) 2001-09-27
AU6212701A (en) 2001-10-03
HK1052465B (zh) 2007-05-11
DE60125345T2 (de) 2007-09-27
ES2276793T3 (es) 2007-07-01
HUP0301059A2 (hu) 2003-07-28
DE60125345D1 (de) 2007-02-01
UA76104C2 (en) 2006-07-17
CN1419454A (zh) 2003-05-21

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